| NPI | 1649210485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: NC 200100226) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200100226) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2013-08-05 |